Trauma Medula Spinalis
Trauma Medula Spinalis
Trauma Medula Spinalis
Muhamad Yunus
Umum :
Posisi netral
Pasien sadar / tidak sadar
Flaccid areflexia
Pernafasan diafragma
Bisa fleksi elbow, ekstensi (-)
Hipotensi + bradikardi, hipovolemik (-)
Priapismus
Trauma Medula Spinalis
Pemeriksaan neurologis :
1. Motorik
Traktus kortikospinal
2. Sensorik
Traktus spinotalamikus
3. Refleks
Posterior collum
4. Otonom
Trauma
Komplit Inkomplit
1. Anterior cord syndrome
2. Central cord syndrome
3. Brown-Sequard syndrome
4. Posterior cord syndrome
Picture
Diagnosis klinis
A: complete
B: incomplete: sensory but not motor
function is preserved below the
neurological level and includes the sacral
Axial pain
segments S4-S5
Radikulopati C: incomplete: motor function is preserved
Parese : para, below the neurological level, and more than
tetra half of key muscles below the neurological
level have a muscle grade less than 3
Plegi : para, tetra strength
D: incomplete: motor function is preserved
below the neurological level, and at least
half of key muscles below the neurological
level have a muscle grade of 3 or more
strength
E: normal
Trauma Medula Spinalis
Spinal shock :
Terjadi sesudah trauma spinal cord
Flaccid
Refleks Babinski (-)
Refleks hiperaktif (-)
Trauma Medula Spinalis
Efek terhadap organ lain :
Paralisis interkostalis hipoventilasi
Paralisis diafragma C3-C5
Trauma abdomen masking effect
Trauma Medula Spinalis
Penatalaksanaan :
Umum :
Tekanan sistolik diperhatikan
Log-rolled pada matras
Khusus :
Medikamentosa
Konservatif
Operatif
Trauma Medula Spinalis
Penatalaksanaan khusus :
Medikamentosa :
Metilprednisolon < 8 jam
30 mg/kgBB, IV, 1 jam pertama
5,4 mg/kgBB drip dalam 23 jam
Trauma Medula Spinalis
Defisit Neurologis
(-) : Konservatif
(+)
Operatif :
Dekompresi
Stabilisasi anterior/posterior
Terima Kasih